Ilya Artemyev

The applicant sought statutory accident benefits following a motor vehicle accident, which were denied by the respondent insurer.

The Licence Appeal Tribunal found that the applicant met her burden of proving that a neurological assessment, a chronic pain assessment, and chiropractic services were reasonable and necessary.

The Tribunal preferred the evidence of the applicant's treating practitioners and experts over the insurer's examiners, noting that the insurer's general practitioner was not qualified to opine on chronic pain and that the insurer's psychologist lacked specific findings to support claims of symptom exaggeration.

The application was granted, and the respondent was ordered to pay the disputed amounts with interest.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to a TMJ assessment and a treatment plan for chiropractic, physiotherapy, and acupuncture services.

The respondent denied the benefits.

The Tribunal found that the applicant failed to prove the TMJ assessment was reasonable and necessary, noting inconsistencies in his self-reporting and preferring the respondent's dental assessor over the applicant's chronic pain specialist.

The Tribunal also found insufficient evidence to support the need for the proposed chiropractic, physiotherapy, and acupuncture services.

The application was dismissed, and no interest was payable.

The applicant sought funding for physiotherapy and psychological services following a motor vehicle accident.

The adjudicator found that the applicant failed to prove the physiotherapy treatment plans were reasonable and necessary, relying on the insurer's section 44 assessor who opined the applicant had reached maximum medical recovery.

The adjudicator also denied the claim for psychological services at a higher hourly rate, finding insufficient evidence to justify paying a psychotherapist at the rate of a psychologist.

The application was dismissed.

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision which found that his accident-related impairments fell within the Minor Injury Guideline (MIG).

The applicant argued that the adjudicator erred in law and fact regarding his psychological impairments and chronic pain syndrome.

The adjudicator dismissed the request, finding that the applicant was attempting to re-weigh evidence and advance new arguments not raised at the initial hearing.

The adjudicator concluded that no errors of law or fact were made that would warrant a reconsideration.